Initiate the dosing regimen for each patient individually, taking into account the patient's prior analgesic treatment experience and risk factors for addiction, abuse, and misuse. Monitor patients closely for respiratory depression, especially within the first 24–72 hours of initiating therapy with Butrans. Butrans should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.
Butrans doses of 7.5, 10, 15, and 20 mcg/hour are for opioid-experienced patients only.
Butrans is for transdermal use (on intact skin) only. Each Butrans patch is intended to be worn for 7 days.
Instruct patients not to use Butrans if the pouch seal is broken or the patch is cut, damaged, or changed in any way and not to cut Butrans.
Discontinue all other around-the-clock opioid drugs when Butrans therapy is initiated.
Select an opioid medication*:
*Patients using fentanyl transdermal system or extended-release hydromorphone for pain control were excluded from the pivotal Butrans clinical trial with opioid-experienced patients whose opioid daily dose prior to enrollment was between 30 and 80 mg morphine equivalents.